JP7094334B2 - End effector and end effector drive device - Google Patents

Description

Cross-references to related applications This application is a US provisional application filed December 29, 2017, entitled "END EFFECTOR AND END EFFECTOR DRIVE APPARATUS", which is incorporated herein by reference in its entirety. Claim the interests of No. 612,220.

The present specification relates to robotic surgical systems and procedures used for minimally invasive surgery. More specifically, the present specification relates to the field of robotic controllers and end effectors useful for use in minimally invasive surgery.

Description of Related Techniques Intraluminal surgical instruments are known, the intracavitary surgical instrument has at least one end effector extending from the distal end of the intracavitary surgical instrument, and the end effector is the jaw of the end effector. It is configured as a 4-bar linkage that allows the opening and closing of the end effector, or the operation of other parts of the end effector that are movable relative to each other, and the operation of the end effector is controlled by pulling the wire connected to the end effector. To. The use of a 4-bar linkage introduces a size constraint on the width (diameter) of the linkage portion of the end effector, which limits the miniaturization of the end effector. In addition, multiple wires are used to control the orientation of the end effector and its opening and closing. These wires extend from the end effector through the flexible tubular member to the coupling device. The coupling device is connected to the end of a wire controller that is configured to pull the individual wires of the wire independently within the end effector or to influence the movement of the end effector. Due to the large number of wires, it is difficult to properly align the wire controller elements used to draw the individual wires of the wire independently, resulting in intermittent failure of control over the end effector or individual wires. It results in the inability to connect properly to the wire controller.

End effectors for surgical devices are provided herein, the end effector being a housing with an opening in the outer wall and the outer wall and an opposing first and second wall extending along the opposing sides of the opening. A first actuator that is swivelably coupled to the first wall of the housing, a second actuator that is swivelably coupled to the second wall of the housing, and the first and first actuators within the opening of the housing. Includes a coupling disposed between at least a portion of the two actuators, the coupling comprising opposing first and second ends, each end to a different actuator of the first and second actuators. Combined so that it can be swiveled.

FIG. 6 is a side view of a prior art end effector in a closed position showing a 4-bar linkage without a perimeter body. It is a side view of the end effector of the prior art in an open position which shows the 4 bar linkage without a peripheral body. It is a side view of the end effector of the prior art of FIG. 1 in a closed position including the peripheral body of an end effector. It is a side view of the end effector of the prior art in an open position including a peripheral body. It is a side view of the end effector which shows the internal linkage of an end effector. It is an isometric view of the end effector of FIG. FIG. 3 is an isometric view of the end effector of FIG. 5 in the open position. It is a side view of the end effector of FIG. It is a side view of the end effector of FIG. 5 rotated 90 degrees from the figure of FIG. It is a side view of the 1st side part of the actuator of the end effector of FIG. It is an exploded view of the end effector of FIG. 6 which shows the internal component of an end effector. FIG. 6 is a partial view of the wire used to actuate the end effector of FIG. 6 between the open and closed positions and the position between the open and closed positions. It is a side view of a surgical instrument having an end effector, and the end effector is in a closed position. It is a side view of a surgical instrument having an end effector, and the end effector is in an open position. It is an isometric view of a surgical instrument. FIG. 3 is an isometric view of a surgical instrument separated from a drive housing used to operate and move the surgical instrument. FIG. 16 is a partial isometric view of a controllable drive mechanism housed in the housing of FIG. FIG. 15 is an isometric view of the lever mechanism of the surgical instrument of FIG. FIG. 15 is a cross-sectional view of the adapter coupling of the surgical instrument of FIG. It is an isometric view of the housing and the controllable drive mechanism separated from the surgical instrument. It is an isometric view of the end of the instrument including the two surgical instruments and the lighting and camera parts. FIG. 3 is an isometric view of the edges of two surgical instruments as well as alternative instruments including lighting and camera parts. FIG. 22 is an isometric view of the ends of the alternative device of FIG. 22, wherein the pair of end effectors extend outward of the ends of the end effectors. FIG. 22 is an isometric view of the control end device handle of the alternative device of FIG. FIG. 2 is a schematic view of a diagram view provided by the alternative instrument of FIG. It is an isometric view of a further alternative instrument structure. FIG. 6 is a schematic view of a camera view provided by the alternative device of FIG. FIG. 6 is a schematic view of a camera view provided by the alternative device of FIG.

End effectors are used in robotic surgical procedures that perform procedures within the body cavities of humans, mammals, or other organisms. The end effector can be actuated remotely from, for example, by transmitting a physical force from a location outside the body to a location within the body where the end effector resides.

To minimize the invasiveness of these surgical procedures, the end effector itself must have a minimum diameter on the order of less than 1 centimeter, more typically less than 5 or 6 millimeters. When an end effector is used for a surgical procedure, such as to obtain a tissue sample, suture a closed opening, grab tissue, or do something similar, the end effector is usually the opposite jaw. It will require an opposing jaw that is a portion that can be opened to engage with body tissue or surgical instruments and closed to engage and hold the instrument or body tissue. Further, for excision, the opposing jaws are opposed blades, or blades, and opposed ground plane surfaces, through which the blades pass to excise body tissue. It may include opposing ground plane surfaces. In either case, if the force is transmitted from a location outside the body to an end effector located inside the body, the resulting force at the opposing jaws will grip the tissue or another item. Must be sufficient. The force required to open and close the opposing jaws to each other is usually at or at the end effector location with wires and end effectors extending from the end effector to the location of the flexible tubular member outside the body. It is provided by a spring return mechanism that is integrally located within the effector, or by a pair of wires, each of which can be separately engaged with a portion of the end effector. In addition, end effectors that can be operated by a single wire that traverses over the outer circumference of the shaft within the end effector are known. By separately providing tensile force to one of the opposite ends of the wire or one of the pair of wires, the end effector can operate between the open position and the closed position and the intermediate position between both positions. be.

In the wire movement paradigm described above, the end effector opening and closing mechanism is a 4-bar linkage mechanism, as shown in FIGS. 1 and 2 herein. In this prior art mechanism, the linkage 10 includes a first bar 12, a second bar 14, a third bar 16, and a fourth bar 18. The first ends of the first and second bars 12 and 14 are rotatably connected to the first pin 20 and the first pin 20 is the first of the first and second bars 12 and 14. Extending through the ends, but the first ends of the first and second bars 12, 14 rotate around the first pin 20, and therefore the first and second bars 12, 14 Allows the opposing second ends of the to move in an arc around the first pin 20. The second end of the first bar 12 is rotatably connected to the first end of the fourth bar 18 by a fourth pin 26, the fourth pin 26 being the second of the first bar 12. And extends through the first end of the fourth bar 18, but the second end of the first bar 12 and the first end of the fourth bar 18 are on the fourth pin 26. Rotating around, thus allowing the opposing first end of the first bar 12 and the second end of the fourth bar 18 to move in an arc around the fourth pin 26. .. The second end of the second bar 14 is rotatably connected to the first end of the third bar 16 by a second pin 22 and the second pin 22 is the second of the second bar 14. And extends through the first end of the third bar 16, but the second end of the second bar 14 and the first end of the third bar 16 are of the second pin 22. Rotating around, thus allowing the opposing first end of the second bar 14 and the second end of the third bar 18 to move in an arc around the second pin 22. .. The second ends of the third and fourth bars 16 and 18 are rotatably connected by a third pin 24 extending through the second ends of the third and fourth bars 16 and 18. , Thereby the second end of the third and fourth bars 16 and 18 can freely rotate around the third pin 24 and the first of the third and fourth bars 16 and 18. The end of can be moved along an arc around the third pin 24. In the linkage of FIGS. 1 and 2, the second ends of the third and fourth bars 16 and 18 are formed integrally with the tool extension portions 28 and 30, and the tool extension portions 28 and 30 are here clamped. It is configured as the opposite side of 32 and is shown in the closed position in FIG. 1 and in the open position in FIG.

Referring here to FIGS. 3 and 4, the pin 20 connecting the first ends of the first and second bars 12 and 14 together is outside the opposite side of the first and second bars 12 and 14. Extends to the opposite slot 36 (only one is shown) in the end effector housing 34. Further, the pin 24 connecting the third and fourth bars 16 and 18 is an overall round opening 38 outward from the opposite side of the third and fourth bars 16 and 18 and within the end effector housing 34. Extend within (only one is shown). The longitudinal axis 40 that passes along the longer center of slot 36 is configured to pass through the center 42 or substantially center 42 of the generally round opening 38. The generally round opening 38 is sized to allow the pin 24 to rotate radially within the slot 36, although it is substantially restricted from moving radially within the slot 36.

The wire 44 is located at the distal location of the linkage 10, where the outside of the body, such as an operating device on the proximal end of a flexible tubular member located outside the body when the linkage 10 is disposed inside the body. In the location of the end effector housing 34 distal to the tool extension 28, 30 from the first wire end 46 of the wire 44, in the end effector housing 34, alongside one side of the pin 20. A second wire end 48 at the distal location of the body in which the linkage 10 resides, past the pin 24 and posteriorly through the second side of the pin 20 to the outside of the end effector housing 34. It extends to. In order to transfer the movement of the wire 44 to the 4 bar linkage 10, the actuator clamp 47 is clamped on the wire and swivelly or loosely connected to a pin 20 connecting the first and second bars 12, 14 together. Ru.

In order to actuate the linkage 10, here the wire 44 is used to move the tool extension 28, 30 of the clamp 32 between the closed position of FIGS. 1 and 3 and the open position of FIGS. 2 and 4. The length of the opposite ends 46, 48 of the wire traced over the pin 24 by pulling, pushing, or pulling and pushing to move the clamp 47 towards or away from the pin 24. Move along the direction. The pin 20 is slotted 36 because the pin 24 is secured against movement in the longitudinal axis 40 and the clamp 47 is connected to the pin 20 by moving the wire in the length direction of the wire 44. Moving within the slot 36 along the longitudinal axis, this movement causes the 4-bar linkage to move the tool extension 28, 30 of the clamp 32 between the closed position of FIG. 1 and the open position of FIG. Let me do it. Pulling the wire away from the linkage 10 at the second end 48 of the wire moves the clamp 47 towards the pin 24 and pushes the first and second bars 12, 14 towards the pin 24, resulting in As a result, the third and fourth bars 16 and 18 are pushed toward the pin 24. This is at the connection of the first and fourth bars 12 and 18 at the fourth pin 26 and at the second pin 22 because the pin 24 is fixed against moving in the longitudinal direction of the slot 36. The connecting portions of the second and third bars 14 and 16 are moved outward from the longitudinal axis 40 of the slot 36. Since the third and fourth bars 16 and 18 are rotatably connected at the fourth pin 24, the same and opposite motion as the motion of the bar portion surrounding the pins 22 and 26 is the tool extension 28, 30. Occurs at the distal end of. Therefore, pulling the end 48 of the wire 44 causes the 4 bar linkage 10 to actuate the tool extension 28, 30 to the open positions of FIGS. 2 and 4. Pulling the wire at the first end 46 away from the end effector causes the wire clamp 47 to move away from the pin 24, thereby moving the pins 22, 26 inward towards the longitudinal axis 40 of the slot 36. At the same time, the tool extension 28, 30 is moved away from the pin 24, and thus the same and opposite motion given to the tool extension 28, 30 moves the tool extension 28, 30 towards the closed position shown in FIGS. 1 and 3. ..

The structure of the four-bar linkage 10 requires a relatively long and wide housing 34, within which the working elements of the linkage 10, in particular the bars 12-18, pins 20, 24, slots 36, and openings 38 are located. Must be fixed. In use, the end effector is located at one end of a flexible tubular member or another introduction mechanism into which the wire 44 extends, whereby the end effector housing 34 is a flexible tubular member or another introduction. It is mounted on one end of the mechanism. The length 50 of the end effector housing 34 and the flexibility of the flexible tubular member immediately adjacent to the end effector housing 34 will cause the width 52 of the end effector housing 34 to vary through it when operated by an external drive mechanism. Determine the minimum radius of the arc. The width 52 of the end effector housing 34 depends on the maximum width Wo of the 4 bar linkage 10, where the maximum width Wo is compared to the width Wc that occurs when the tool is in the closed position of FIGS. 1 and 3. Occurs when in its maximum open position as shown in FIGS. 2 and 4, the outer diameter or maximum width of the end effector housing 34 is this width because a portion of the end effector housing 34 extends over the 4 bar linkage 10. Greater than Wo. Therefore, the width 52 of the end effector housing 34 must be open in the body to introduce an opening area into which the end effector can be introduced, and a flexible tubular member having a linkage 10 on it. Limit the size of the opening. The length of the bar affects the width Wo, as well as the maximum opening angle of the tool extension 28, 30 around the third pin 24. Therefore, a practical limitation on the size of the end effector housing limits the opening angle of the tool extension 28, 30. These sizes limit the function and usefulness of the 4 bar linkage 10.

A flexible tubular member in which an end effector housing 34 containing a 4 bar linkage 10 is mounted on its distal end in order to move the wire 44 in the prior art and thus allow the movement of the 4 bar linkage 10. The proximal end is connected to an adapter coupling 252 (eg, see FIG. 15) that is releasably connectable to a controllable drive mechanism, and each is distal to the flexible tubular member through the flexible tubular member. Includes a plurality of wire magnets M (FIG. 19) coupled to the proximal end of the wire 44 extending from the end to the adapter coupling 252. The magnet M is magnetically coupled to a magnetic pole m'(FIG. 16) which can be a magnet or slug containing a ferromagnetic material, thereby biasing it into contact with the magnetic pole m'and then a controllable drive member. Connected to a control wire that extends from. To affect the movement of the 4 bar linkage 10, one of the two wire ends 46, 48 is pulled directly through this magnetic linkage towards the controllable drive mechanism and the other wire ends 46 or 48 Brings to being pulled away from the controllable drive mechanism. In this structure, there is a risk that the magnetic members M, m'separate as the controllable drive mechanism pulls the wire connected to m', thus based on the strength of the magnetic attraction between M and m'. Therefore, there is a limit to the force that can be applied to pull the magnet M towards the controllable drive mechanism.

Further, in another prior art structure, the magnet M on the end of the wire 44 is replaced with a hook mechanism, as is the pole m'. In this structure, greater force may be applied to pull the wire ends 46, 48 towards the controllable drive mechanism, but it makes it difficult to make a connection of the wire ends 46, 48 to the controllable drive mechanism. There is a difficulty in aligning each hook, and the physical size of the hook limits the minimum size of the adapter coupling that can be used.

With reference to FIGS. 5-9, the end effector 100 is provided here, which is a tool superior to the overall length and width of the 4 bar linkage 10 of the prior art end effectors shown in FIGS. Allows for a significant reduction in overall length and width of the movement mechanism, thus allowing a shorter and thinner end effector 100. The end effector 100 is generally connected to one of a first side actuator 102, a second side actuator 104, a coupling link 106, a housing 108, and first and second side actuators 102, 104. Includes wire 110. As with the end effector housing 34, the end effector 100 is mounted at the distal end of the flexible tubular member so that the opposed ends 114, 116 of the wire 110 are flexible located outside the body. It extends outwardly of the proximal end 221 of the sex tubular member.

The housing 108 is configured to internally receive the swivel pin ends 122, 124 and the coupling link 106 of the first and second side actuators 102, 104, respectively, and thus extends from the base 126 and the base 126, respectively. Includes first and second upright portions 128, 130 to form a slot 132 (see, eg, FIG. 6) between them. Here, the base 126 and the upright portions 128, 130 are integrally formed and machined from a single piece of biocompatible metal such as stainless steel, or biocompatible by an additive process such as 3D printing. Formed of material. Each upright portion 128, 130 includes a pair of pin openings 134, 136 inside, and the center lines of the pin openings 134 in the upright portions 128, 130 facing each other are aligned in the same straight line across the slot 132. The first swivel pin 138 extends from the pin opening 134 and is supported within the pin opening 134, and also within the opening or hole 121 (see FIG. 11) in the swivel pin end 122 of the first side actuator 102. It extends to. The first swivel pin 138 is sized to interfere with the inner wall of the pin opening 134 to prevent rotation of the first swivel pin 138 within the inner wall, while the first side portion. The hole 121 in the actuator 102 is slightly larger than the outer circumference of the first swivel pin 138, allowing the first side actuator 102 to follow over the first swivel pin 138 and move freely. Alternatively, the hole 121 in the first side actuator 102 is slightly smaller than the outer circumference of the first swivel pin 138, and the pin opening 134 is slightly larger than the outer circumference of the first swivel pin 138. It allows the swivel pin 138 to rotate within the pin opening 134 and the first side actuator 102 to move in an arc with respect to the pin opening 134. The second swivel pin 140 extends from the pin opening 136 and is supported within the pin opening 136, and also within the opening or hole 121 (see FIG. 11) in the swivel pin end 124 of the second side actuator 104. It extends to. The second swivel pin 140 is sized to interfere with the inner wall of the pin opening 136 to prevent rotation of the second swivel pin 136 within the inner wall, while the second side portion. The hole 121 in the actuator 104 is slightly larger than the outer circumference of the second swivel pin 140, allowing the second side actuator 104 to follow over the second swivel pin 140 and move freely. Alternatively, the hole 121 in the second side actuator 104 is slightly smaller than the outer circumference of the second swivel pin 140, the pin opening 136 is slightly larger than the outer circumference of the second swivel pin 140, and the second. It allows the swivel pin 140 to rotate within the pin opening 136 and the second side actuator 104 to move in an arc with respect to the pin opening 136.

The coupling link 106 is disposed between the swivel pin ends 122, 124 of the first and second side actuators 102, 104 located in the slot 132, and at the opposite ends of the coupling link 106, the first and second. The first and second pins 144 and 146 are connected to different swivel pin ends of the swivel pin ends 122 and 124 of the second side actuators 102 and 104. The first pin 144 is the first side portion of the coupling link 106 from the first end at the location between the connection of the swivel pin 138 to the first side actuator 122 and the center line 150 of the end effector. Extending within the swivel pin end 122 of the actuator 102, the second pin 146 is a cup at a location between the connection of the swivel pin 140 to the second side actuator 104 and the centerline 150 of the end effector 100. It extends from the second end of the ring link 106 into the swivel pin end 124 of the second side actuator 104. Within slot 132, there was a slight gap between the side of the coupling link 106 and the adjacent facing surfaces of the swivel pin ends 122, 124 of the first and second side actuators 102, 104. Up to this point, the first and second side actuators 102, 104 can move relative to each other in a sliding motion with minimal interference from each other.

Each of the first and second side actuators 102, 104 includes tool portions 152, 154, respectively, where each tool portion 152, 154 is a first and second side actuator 102, 104, respectively. It constitutes half of a pair of clamping jaws connected to the swivel pin ends 122, 124 of the actuator. The first and second side actuators 102, 104 include, here, a continuous piece of material forming the swivel pin end 122 and the tool portion 152 and the swivel pin end 124 and the tool portion 154, such as stainless steel. Machined from a single piece of biocompatible metal or formed of biocompatible material by additive processes such as 3D printing. As shown in FIG. 11, the end tool portions 152, 154 are spaced apart, here extending over the distal ends of the generally parallel sidewalls 160, 162, 160, 162, and the sidewalls 160, 162. The end wall 168, which terminates at the opposite end of the distal end, the base wall 172, which extends entirely parallel to the end wall 168 and terminates at the opposite end of the end wall 168 of the side walls 160, 162, and the side wall 160, It is bounded by a front grip surface 158 bounded by 162, an end wall 168, and a base wall 172. On the sides of the tool portions 152 and 154 facing the grip surface 158, the sidewalls 160, 162 extend posteriorly along the arcuate contour and after each tool portion 152, 154 adjacent to the base wall 172. The chamfered surface 176, which is in contact with the end 174 and is generally flat, extends away from the gripping surface 158 in the direction from the end wall 168 toward the base wall 172 and ends at the side walls 160, 162 before reaching the base wall 172. The swivel pin ends 122, 124 extend from the base wall 172, generally parallel to the center line 178 of the gripping surface 158 and offset from the center line 178 in the direction of the side wall 160. As a result of this offset, the walls 156 facing the coupling link at the swivel pin ends 122, 124 face each other when mounted in the slot of the housing 108 by a distance slightly longer than the coupling link 106, thereby the cup. The ring link 106 can be located between the swivel pin ends 122, 124 and the aforementioned relative sliding motion of the side portion of the coupling link 106 with respect to the wall 156 towards the coupling link of tool portions 152, 154. Not limited.

Here, the end effector 100 has the same shape and size so that the first and second side actuators 102, 104, respectively, are substantially identical and interchangeable, within the end effector housing 108. When assembled, they are configured to show mirror symmetry with each other over the centerline 150. However, the first side actuator 102 includes an additional wire fixing recess 155 along the wall 156 of its swivel pin end 122 towards the coupling link 106 and receives the pin, as shown in FIGS. 10 and 11. The location of the opening at the swivel pin end 122 may vary. Here, the wire fixing recess 155 is a wire slot between the two bosses 157 and 159 extending outward from the wall of the swivel pin end 102 facing the coupling link 106 to the tool portion 152. Coupling during operation of tool portions 152, 154 of the end effector 100 at a location on the swivel pin end 102 distally spaced from the penetration of the swivel pin end 102, and also as further herein. The link 106 is provided as a wire slot formed outside the location where it must travel.

Referring now to FIG. 11, the housing 108 faces the slot 184, 186 of the housing 108 in order to close the gap between the slot facing walls 184 and 186 at a location extending from the base 126 to the distal slot 132. Further includes a pair of wire guides 180, 182 extending from and towards each other. Each of the wire guides 180, 182 is mirror symmetric over a virtual plane extending along the center of the slot 132 parallel to the wall 184, 186 facing the slot, and the wire guide 180 is along the wall 184 facing the slot. The wire guide 182 is offset in the direction of the pin opening 134, while the wire guide 182 is offset in the direction of the pin opening 136 along the wall 186 facing the slot. Each wire guide 180, 182 includes an upper side wall 188 extending over the slot 132, the upper side wall 188 extending from the upper side wall 188 in the direction of the slot and in the direction of the wall 184 or 186 facing the opposite slot. Terminated at a contoured wall 192 that bends to, the wire-bearing surface 190 extends from the contoured wall to the inner end wall 198 that forms the internal termination of the respective wire guides 180, 182 within slot 132. In each of the wire guides 180 and 182, the distance from the slot side walls 184 and 186 to the end wall 198 of the wire guides 180 or 182 extending from the slot side walls 184 and 186 is half the distance between the slot side walls 184 and 186. Larger, the distance from the slot sidewalls 184 and 186 to the upper end of the upper sidewall 188 of the wire guide 180 or 182 extending from the slot sidewalls 184 and 186 is less than half the spacing between the slot sidewalls 184 and 186. Therefore, the resulting spacing or gap between the walls 184 and 186 facing the slot of the slot 132 and between the wire guides 180 and 182 in the anteroposterior direction of the slot 132 is greater than the diameter of the wire 110. Slightly large. Therefore, the upper side wall 188, the contoured wall 192, and the wire carrier wall 190 together form a grooved recess 191 and the wire moves as the wire moves to open and close the tool end of the end effector 100. To induce. Each wire guide 180, 182 similarly includes a side wall 194, one wire guide 180 or 182 side wall 194 pointing in a direction facing the other wire guide 180 or 182 side wall 194, thereby facing a slot. Adjacent portions of the wall 184 or 186 and the end walls 198 of the wire guides 180, 182 and other wire guides form an overall rectangular recess 200. The width of the recess 200 between the end wall 198 and the side walls 184 and 186 facing the slot is slightly greater than the width 202 of the swivel pin ends 122, 124. In addition, the planes formed by each of the generally flat sidewalls 194 are coplanar with or nearly aligned with each other. The extension wall 206 on the swivel pin ends 122, 124 is formed as an entirely coplanar extension of the gripping surface 158. As a result, the side wall 194 forms a limiting wall that limits the movement of the gripping surfaces 158 towards each other. Further, the base walls 172 of the first and second actuators 102, 104 cooperate with the grooved recess 191 to form a tunnel or conduit that borders the portion of the wire 110 in the grooved recess 191 on four sides. It is configured to do. When the first and second actuators 102, 104 are in the closed positions of FIGS. 5, 6, and 8, the base wall 172 of the first and second actuators 102, 104 is the true groove recess 191. Located on top. When the first and second actuators 102, 104 are in the open position of FIG. 7, the base wall 172 of the first and second actuators 102, 104 is equidistant from the centerline 150 of the end effector 100. It is separated from the place 191.

Referring to FIGS. 10 and 12, the wire 110 includes a slag 208 formed on the wire 110 that provides a larger diameter portion of the wire 110. Correspondingly, the wire fixing recess 155 includes an increase width region 208a, which has an overall round detent 210 facing each other over the increase width region 208a. The volume of the slag 208 on the wire 110 is larger than the volume of the portion of the wire fixing recess 155 provided between the detent 210s and therefore within the volume of the increased width region 208a of the wire fixing recess 155 at the location of the detent 210. By pushing the slug 208 into the wire 110, the wire 110 can be anchored against movement with respect to the wire anchoring recess 155. Alternatively, the wire 110 is two slugs separated from each other by the length of the wire fixing recess 155, whereby the slags are located on either side of the wire fixing recess, or the wire. It can include a single slag that is drawn into the anchorage and maintained within the wire anchorage by friction. Further, instead of a single wire passing through the wire fixing recess 155, two different wire ends provide a slug at that end and the slug is located within the same or different recess 210, or first. And wire fixing recesses 155 are provided on each of the second actuators 102, 104, and a wire guide is provided before connecting each wire end to the corresponding wire fixing recess of one of the wire fixing recesses 155. It can be fixed at different locations in the wire fixing recess 155, such as by passing it over 180, 182.

Referring to FIG. 5, in order to operate the end effector 100, as described above herein, the end while allowing the second end 116 of the wire 110 to move towards the end effector 100. Pulling the first end 114 of the wire 110 away from the effector 100, or pointing the second end 116 towards the end effector 100 at the same rate that the first end 114 is pulled away from the end effector 100. When positively released, the tool portions 152, 154 of the end effector will move away from each other from the positions of FIGS. 5, 6, and 8 to the position of FIG. 7, and the wire ends 114, 116. By reversing the action of pulling and releasing the robot end effector, the tool portions 152 and 154 of the end effector move toward each other from the position of FIG. 7 to the positions of FIGS. 5, 6, and 8. In the end effector 100, this movement of tool portions 152, 154 is accomplished by the use of the coupling link 106, and as a result, the length 212 of the housing 108 of the end effector 100 incorporating the coupling link is the conventional length 212 shown in FIG. The length of the end effector housing 34 of the art is shorter than 50, and the width 214 of the housing 108 of the end effector 100 incorporating the coupling link is shorter than the width 52 of the prior art end effector housing 34 shown in FIG.

The openings 216 and 218 in the swivel pin ends 122 and 124 are located relative to the openings or holes 121 in the swivel pin ends 122 and 124 that receive the first or second swivel pins 138 and 140, respectively, of the wire 110. It is ensured that the ends 114, 116 provide the opening and closing of the tool portions 152, 154 described above. As a result, at the closed position of the tool portions 152 and 154 shown in FIG. 5, the first and second pins 144 and 146 pass through the coupling link 106 and extend from the opposite sides of the coupling link 106. The virtual line extending through the extension of the center line forms an acute angle α with respect to the end effector 100 center line 150, and the center of the outer periphery of each of the first and second pins 144 and 146 is It is located on the opposite side of the center line 150. At the positions of the tool portions 152 and 154 shown in FIG. 7, the respective pins 144 and 146 of the first and second pins are also located on the opposite sides of the center line 150 and further separated from the pin. However, the location of the first swivel pin 138 with respect to the first pin 144 of the coupling link 106 and the location of the second swivel pin 140 with respect to the first pin 144 of the coupling link 106 are fixed. Therefore, the rotational movement of the first pin end 122 around the first swivel pin 138 results in the same and opposite rotational movement of the second pin end 124 around the second swivel pin 140. When the end 114 of the wire 110 is pulled by fixing the wire connected to one of the swivel pin ends 122, 124, here the swivel pin end 122, the slug 208 on the wire 110 has a wire fixing recess 155, Therefore, the end of the swivel pin end 122 is pulled farthest from the gripping surface 158 of the first tool portion in the direction of the wire guides 180, 182. This motion is transmitted through the first pin 144 of the coupling link 106 to the second pin 146 of the coupling link 106 and to the swivel pin end 124 so that the swivel pin end 124 is around the second swivel pin 140. Rotate to so that the ends of the swivel pin ends 124 distal to the grip surface 158 move similarly in the direction of the wire guides 180, 182 so that the grip surfaces 158 are separated from each other by the same arcuate motion. Bring. Reversing the pull of the wire 110 to pull the second end 116 of the wire 110 results in the same and opposite motion of the gripping surface 158 as well.

With reference to FIGS. 13 and 14, the end effector 100 is shown in a portion of the surgical instrument 220 to which the end effector 100 is attached to the first open end 224 of the flexible tubular member 222. Through 222, the wire 44 enters the hollow interior of the flexible tubular member 222 from the first wire end 46 of the wire 44, distally from the end 226 of the flexible tubular member 222, and distally from the end effector 100. Extends through the end effector 100, where the wire 44 is connected to a wire fixing recess 155 along the wall 156 towards the coupling link 106 of the swivel pin end 122 of the first side actuator 102. It then returns through the hollow interior of the flexible tubular member 222 to the second wire end 48. Separate the wire from the end effector 100 while releasing the wire end 48 inward of the flexible tubular member 222 or allowing the wire end 48 to move inward of the flexible tubular member 222. By pulling to the first end 46, the end effector eventually moves towards the closed position in FIG. 13 to the closed position. The wire is end-effector while releasing the first end 46 inward of the flexible tubular member 222 or allowing the first end 46 to move inward of the flexible tubular member 222. By pulling away from 100 and towards the second end 48, the end effector eventually moves towards the open position in FIG. 14 to the closed position. The flexible tubular member 222 is an overall hollow, bendable and steerable tube or lumen, thus the flexible tubular member 222 directs the end effector 100 to a desired location within the body. Used in robotic surgical systems, at the desired location, the end effector 100 can spread adjacent to body tissue to grab an object or perform another operation. Similarly, tool portions 152 and 154 of the end effector 100 are a pair of blades or excision elements or excision elements and ground portions that may be configured as ground portions that pass to their sides to slice body tissue. .. Pulling and releasing the wire 44 of the end effector 100 is used to open and close the combination of blades or blade ground portions to operate the end effector 100.

Referring now to FIGS. 15 and 16, a surgical instrument 220 configured to be releasably mounted on a controllable drive mechanism 250 (FIG. 17) is shown. As used herein, the surgical instrument 220 is a flexible tubular member 222, the flexible tubular member 222 having an end effector 100 connected to the distal end of the flexible tubular member 222, and possible. Includes an adapter coupling 252 connected to the proximal end 221 of the flexible tubular member 222. As described herein, the adapter coupling 252 is releasably connectable to the controllable drive mechanism 250 by being positioned on a boss 251 extending from the controllable drive mechanism 250 and is a controllable drive mechanism. Includes a plurality of wire actuating members that are selectively movable with respect to the adapter coupling 252 under the control of 250. The flexible tubular member 222 is configured to include, at its ends, a controllably bendable coupling 296 with one or more degrees of freedom, the movement of the coupling 296 in bending movement and the operation of the end effector 100. Control is achieved using wire 297, which is the distal end 223 of the flexible tubular member 222 on which the flexible coupling 296 and its distal end effector 100 are located, and the end of wire 297. That is, the wire ends 298a and 298b (eg, having the wire ends 46 and 48 of FIGS. 5-11) extend between the accessible and proximal ends 221 of the flexible tubular member 222. Each wire 297 used for control and positioning of the end effector 100 or the flexible coupling 296 has opposite wire ends 298a and 298b accessible at the proximal end 221 of the flexible tubular member 222. Can be provided. Here, 10 wires with 10 wire ends 298 extending outward of the proximal end 221 of the flexible tubular member 222 are used, and each of the five pairs of wire ends 298a and 298b is bendable. Connected to the same portion of the coupling 298, the end effector 100, or another flexible tubular member distal end component, thereby one of a pair relative to the distal end 221 of the flexible tubular member 222. Pulling the wire ends 298a and 298b results in the same and opposite motion of the other wire ends 298a and 298b relative to the distal end 223 of the flexible tubular member 222. In FIG. 15, there are a total of 10 wire ends 298 with 5 ends 298a and 5 ends 298b, each wire end 298a being end effector 100 or bendable at the distal end 223 of the flexible tubular member 222. Through the coupling, it is coupled to the other wire end 298b of the same wire 297. Wire 297, in this case each of the five wires 297, passes through one of the flexible coupling 296, the end effector 100, or both and returns to the distal end 221 of the flexible tubular member 222, or , Each of the wires 297 extends only between the distal end 221 and the end effector 100 or the flexible coupling 296, but a pair of such wires is an end effector such that the wires are associated in pairs. Or connected to each of the elements of the flexible coupling. Selective pulling of the wire ends 298a and 298b relative to the distal end 221 of the flexible tubular member 222 results in the movement of the flexible coupling 296 or the end effector 100, thereby the flexible tubular member 222. The associated or connected wire ends 298a and 298b accessible at the proximal end 221 of the are useful for activating the end effector 100 or the flexible coupling 296.

FIG. 17 shows a controllable drive mechanism 250, the outer housing of which has been removed for clarity of understanding, and only one lead screw mechanism 254 is shown therein. Wire ends 298, eg, individual wires of wire ends 46, 48 of wire 297 coupled to the end effector 100 described above herein, into the distal end 221 of the flexible tubular member 222. Also, for outward movement, each of the wire ends 298a, 298b, including the wire ends 46, 48, is individually coupled to a lead screw mechanism 254 dedicated to the wire end and located within the housing 256, and each lead. The screw mechanism 254 is a lead screw housing 258, which is physically connected to the housing 256 and is grounded against rotation and axial movement by the housing 256, with a lead screw housing 258, a motor 260, and threads. The shaft 262 includes a threaded shaft 262 and a connecting bracket 268 configured to have a male thread (not shown) on it, wherein the connecting bracket 268 contains a threaded shaft 262. A first connector portion 270 with a female thread extending into, an extension member 272 extending distally from the first connector portion 270 away from the motor 260, and an end of the extension member 272 distal to the motor 260. It has a second connector portion 274. The connection bracket 268 can move freely in the axial direction of the threaded shaft 262 as a result of the motion imparted to the connection bracket 268 by the rotational movement of the threaded shaft 262, but inside the outer surface of the housing 256. It is received in the groove 267 extending in the groove 267 and is rotatably fixed to the housing 256 through a pawl 266 slidable axially with respect to the groove 267 to be grounded against rotation. As used herein, ten lead screw mechanisms 254, each with a pawl 266 and a groove 267 uniquely coupled to the pawl 266, are circumferentially equivalent from each other around the housing 256 on a controllable drive mechanism 250. It is provided at intervals. The second connector portion 274 extends from the lead screw housing 258 into the bore 278 (see FIG. 16) in the boss 251 of the drive mechanism 250.

As used herein, in order to overcome the shortcomings of the prior art magnetic coupling or hook connection paradigm, the adapter coupling 252 is modified so that each wire 298 is attached to a dedicated magnet mounted on the second connector portion 274. Directly magnetically coupled and pull the wire end outward of the proximal end 221 of the flexible tubular member 222, rather than using the pulling action of the second connector portion 274, as shown in FIG. The wire ends 298 including 46, 48 are respectively connected to the first end 284 of the lever assembly 286, and the other second end 288 of the lever assembly 286 is the proximal end 221 of the flexible tubular member 222. As a result of the movement of one connector portion of the second connector portion 274 coupled to the second end 288 towards or away from it, towards or away from the proximal end 221 of the flexible tubular member 222. It is movable away from it, whereby the movement of the second connector portion 274 towards the proximal end 221 of the flexible tubular member 222 is separated from the proximal end 221 of the flexible tubular member 222, the first. It results in the pulling of the wire ends 46, 48 connected to the end 284. To enable this lever movement, a fulcrum 290 is provided on the fulcrum post 292 extending from a surface 253 facing the proximal end of the adapter coupling 252, with the end of the fulcrum 290 facing the lever assembly 286. It is connected through a hinge pin 294 to the location of the lever assembly 286 between the first and second ends 284 and 288. The movement of the lead screw, which causes the second connector portion 274 to push one end of the lever through the lever assembly 286, causes the wire ends 298, in this case the wire ends 46 and 48, to be proximal ends of the flexible tubular member 222. By allowing the hook to be pulled away from 221 the first magnet away from the second magnet in tolerance matching problems where hooks are used for connection as well as magnetic coupling affecting wire end 298 motion. The problem with pulling is gone, because the movement of the second connector portion 274 inward of the adapter, i.e. towards the distal end of the flexible tubular member 222, is now the lever assembly 286. This is because it causes the pulling motion of the wire end 298 by the first end 284 of. Therefore, the magnetic coupling between the magnet for pulling the wire end and the magnet and slug on the wire end to affect the operation of the distal end of the effector or flexible tubular member 222 is loose (pull apart). ) Eliminates the risk of becoming, the force transmitted to the wire end 298 and the rate of change of that force pulling the wire end 298 to affect the pulling of the wire end, so that the magnet is connected to another magnet or slug. It is affected by pushing the lever, not by pulling.

Also referring to FIG. 15, the adapter coupling 252 is configured as an overall circular cylindrical member including the mounting portion 300 so that the mounting portion 300 is releasably mounted on the boss 251 of the controllable drive mechanism 250. A plurality of attachment portions 300 are configured to form a second connector portion 272 that includes a front surface 302 and is equal in number to the number of wire ends 298 extending from the proximal end 221 of the flexible tubular member 222. The plunger 304 slidably extends or retracts with respect to the mounting portion 300 (see FIG. 19 where the left plunger 304 extends and the right plunger 304 retracts), and each of the plungers 304 has a second end hinge pin. Through 306, it is connected to the second end 288 of one lever assembly 286 of the plurality of lever assemblies 286.

As shown in FIG. 18, the plurality of lever assemblies 286 include a base plate 310, the base plate 310 having a pair of opposing principal planes extending through which a hinge pin opening 312 and an opposing minor wall 314. 316, with opposing minor walls 314, 316, including arm bores extending within the minor walls 314, 316. The first arm 318 extends from the wall 314 and terminates at the first lever end 284, and the wire opening 321 attaches the first arm 318 slightly inward to the end of the first lever end 284. It penetrates and extends. The first arm 318 extends entirely perpendicular to the wall 314 from the wall 314, and the centerline of the first arm 318 extends through the center of the hinge pin opening 312. The first arm 318 is press-fitted or screwed into the corresponding opening in the wall 314. The second arm 320 extends entirely vertically from the opposing wall 316 and is press-fitted or screwed into the corresponding opening in the wall 316. The longitudinal axis of the second arm 320 is offset from the longitudinal axis of the first arm 318 away from the adapter coupling 252, and the distal end of the second arm 320 penetrates the swivel pin. It terminates with an increased overall right-angled cylindrical bushing 322 with an extended opening 324.

Referring here to FIGS. 15 and 19, the adapter coupling 252 is an entirely right-angled cylindrical body interconnected by two screw fasteners, etc., in this case the base 326 and the cover 328. It is composed of a cover 328 on which a coupling surface 282 is provided. The base 326 includes a rear surface 332 and a front surface 334 on which the cover 328 is received, the main portion 330 having the front surface 334, and the circumferential thin wall ferrule 336 covers the main portion 330 and the cover. Partially disposed between 328 and includes a plurality of lock pawls (not shown). The counterbore 338 extends approximately in the center of the main portion 330 and inward of the rear wall 332 of the main portion 330. The plurality of first bores 340 extend through the base from the front surface 334 to the rear surface 332 of the base, and the center of the first bore 340 is centered on the center line 344 of the adapter coupling 252. Located along the circumference of 1, the annular cylindrical bushing is located within the first bore 340. The first bores 340 are equidistant from each other along the first circumference.

The cover 328 is a surface 253 facing the proximal end, a rear surface 345 on the opposite side of the surface 253, a circumferential wall 350 disposed inward of the ferrule 336, and a plurality of second bores, a circle. It has a center at circumference 342 and includes a plurality of second bores that are equidistant from each other along the first circumference. The first and second bores have the same diameter and are angularly aligned along the circumference 342 so that a continuous bushing bore 352 is formed, thereby an annular cylinder within the continuous bushing bore 352. A bushing 347 is disposed. Multiple fulcrum posts 292 extend from the surface 253 facing the proximal end, terminate at fulcrum 290 with an opening extending through the fulcrum 290, and extend through the opening through the hinge pin opening 312. A swivel pin 285 is further extended to connect the lever arm to the fulcrum post 292. The plurality of fulcrum posts 292 are circularly spaced around the circumference of the circumference at equal intervals in an arc shape, having a second diameter smaller than the first diameter and having a centered circumference of the adapter coupling 252. do. The center of each fulcrum post 292 is positioned along a radius extending from the centerline 344 of the adapter to the inner location of the center of one bushing bore of the bushing bore 352.

The movement of the wire end 298 towards the front surface 302 of the adapter coupling 252 is triggered by the movement of the second end 288 of the lever assembly 286 away from the front surface 302. In order to enable this movement and to carry out this movement in a controllable manner, each second end 288 of the lever assembly 286 is connected to a plunger 304 dedicated to the second end 288. 304 is connected to a bushing 356 dedicated to the plunger 304 and reciprocally sliding within the annular cylindrical bushing 347 in the bushing bore 352, the rear side 358 of the bushing 356 being the drive recess 360 and the rear side. Includes a drive recess 360 that extends within 358 and terminates at an overall circular base 361 wall within the drive recess 360, within the drive recess 360 at the end of the distal extension member of the motor 260. The second connector portion 274 (FIG. 17) extends. The bushing 356 includes a recess 308 extending inwardly on its outer circumference, the lock pawl on the ferrule 336 is selectively actuable by rotation of the ferrule 336 and the bushing 356 within the bushing bore 352. Extends inward of the outer peripheral recess 308 to limit the stroke of. Here, the plunger 304 is an overall U-shaped member having a base 362 connected to the center of the upper surface of the bushing 356, the pin 364 extending through the base 362 and above the bushing 356. Press-fitted or screwed into a bore provided for the base 362 in the surface, the pair of arms 366, 368 (FIG. 15) extend from the opposite end of the base 362 away from the bushing 356. A pair of aligned openings are located inward of the ends of the arms 366 and 368 separated from the bushing 356, whereby the second end hinge pin 306 is located in the openings in the arm 366, in the second arm bushing 322. A second swivel pin opening 324 and extending through the opening in the arm 368 allows the lever assembly 286 to swing around the second end hinge pin 306. Plungers and adapters can be made of metals such as aluminum or steel, engineering polymers, or a combination thereof. The bushing 356 and the plunger 304 can be similarly configured as a single piece member with an engineering polymer or a metal such as aluminum.

The first and second wire ends 46, 48 (FIG. 13) of the wire 44 extend from the distal end of the flexible tubular member 222 and extend from the distal ends of the flexible tubular members 222, respectively, wire ends 298a, 298b, where wire ends 46, 48. Is fixed to the wire opening 321 in the first arm 318 of the different lever assembly 286, here to the first arms 318a, 318b for ease of understanding. In FIG. 19, the second wire end 48 is pulled away from the proximal end 221 of the flexible tubular member 222 by the movement of the first arm 318a, and the first wire end 46 is flexible. It results in being pulled towards the proximal end 221 of the tubular member 222, because the wire ends 46, 48 are opposite ends of the same wire 44, and the wire 44 is approximately between the wire ends 46, 48. This is because, in the middle, the end effector 100 is fixedly connected to the first side actuator 102 at the wire fixing recess 155 (FIG. 10) of the first side actuator 102. At these positions of the lever assembly 286 and the wire ends 46, 48, the end effector 100 is in the open position of FIG. In this position, the lead screw of one of the lead screw devices pushes the plunger of one of the plungers 304a from the rear surface 332 of the adapter coupling 252 into the adapter coupling 252, and the plunger 304a pushes the adapter coupling 252 inward. Move away from the lever arm to push the second arm 320a, thereby moving the end of the first arm 318a towards the anterior surface 302 of the adapter coupling 252, thereby the second wire. The end 48 was provided as a result of pulling away from the proximal end 221 of the flexible tubular member 222. This pulls the first wire end 46 towards the proximal end 221 of the flexible tubular member 222 and pulls the lever arm of the lever assembly 286 attached to the first wire end 46 into a hinge pin on the fulcrum 290. Swinging around 294, the bushing 322 on the second arm 320b of the lever assembly 286 pushes the end of the plunger 304b attached to the bushing 322 toward the front surface 302 of the adapter coupling 252. As a result, the plunger 304b is pushed in the direction toward the rear surface 332 of the adapter coupling 252 so that the rear side of the plunger 304b extends to the outside of the rear surface 332. Inversion of the plunger 304b attached to the first arm 318b of the lever assembly 286 attached to the first wire end 46 flexes the first wire end 46. Pull away from the proximal end 221 of the sex tubular member 222, thereby moving the jaw of the end effector 100 towards or to the position of FIG. 13 to allow the second wire end 48. The adapter coupling ends of the plunger 304a attached to the lever assembly 286 through the lever assembly 286 attached to the second wire end 48 by pulling towards the proximal end 221 of the flexible tubular member 222. The bushing 356 attached to the lever assembly 286 is therefore pushed inward of the adapter coupling 252 towards the front surface 302 of the 252, whereby the rear end of the plunger 304a extends outward of the rear wall 332. There is.

As used herein, the lead screw mechanism 254 (FIG. 17) is dedicated to providing a pushing force that moves the second arm 320 of the lever assembly 286 away from the anterior surface 302 of the adapter coupling 252. The force is transmitted to the wire, here wire 44, to the wire end 46 or 48 of the adapter coupling 252 that is not pulled by the second arm 320 in the direction towards the front surface 302 of the adapter coupling 252. It is moved away from the front surface 302, and thus the plunger 304 and bushing 356 connected to the second arm 320 are moved toward or inward of the front surface 302 of the adapter coupling 252.

Using the movement of the wire 44 and the wire ends 46, 48 as an example, the second connector portion 274 (FIG. 17) connected to the shaft 262 through the connecting bracket 268 for linear movement of the second connector portion 274. Through the second arm 320b (see FIG. 19), contact with the circular base wall 361 of the drive recess 360 of the bushing 356b connected to the plunger 304 connected to the second arm of the lever 286 connected to the wire end 48. Located in the state. At the same time, the second connector portion 274a connected to a different shaft through the connecting bracket for linear movement of the second connector portion 274a is the second of the lever 286 connected to the wire end 46 through the second arm 320a. It is located in contact with the circular base wall 361 of the drive recess 360 of the bushing 356a connected to the plunger 304 connected to the arm of the. To cause the movement of the wire ends 46, 48, the motor 254 is connected to the second connector portion 274a through the connecting bracket 268, moving the second connector portion 274a in the direction towards the motor 254, a different motor 254. Is connected to the second connector portion 274b through the connection bracket 268 to move the second connector portion 274b away from the motor 254 and the second connector portion 274a, 274b with respect to the front surface 302 of the adapter coupling 252. The speed of movement is the same, but in the opposite direction. Since there is no "hard" connection between the second connector portion 274a, 274b and the bushing 356a, 356b, the movement of the bushing 356a in the direction of the motor 254 makes the wire end 46 a flexible tubular. Pulling towards the proximal end 221 of the member 222 causes the wire end 48 to be completely pulled away from the proximal end 221 of the flexible tubular member 222. The movement of the wire end 48 away from the proximal end 221 of the flexible tubular member 222 is a linear movement induced by another motor 254 through the lever assembly 286 and a second in opposite direction at the same speed. Since it is a function of the motor 254 of the connector portion 274a, all the structures of the lever, the bushing, and the plunger are the same, so that the bushing 356a moves in the opposite direction to the bushing 356b but at the same speed. As the second connector portion 274a retracts towards the motor 254, the circular base wall 361 of the bushing 356a has the second connector at the same speed as the second connector portion 274a retracts towards the motor 254. It will follow the portion 274a. If the motor rotation direction is reversed, the same effect will occur, albeit in reverse. Therefore, there is no need to physically connect the second connector portion 274 and the bushing 356, and there is no need for complicated alignment between the two to position the adapter on the boss 251 of the controllable drive member 250. Bring in. Similarly, the movement of the wire ends 46, 48 is achieved by pushing the bushings 356a, 356b, causing the wire ends 46 or 48, and thus the opposite movement of the wire 44, and thus the lead screw from the wire 44 during use. There is no risk of being blocked from exercise.

Also referring to FIG. 15, the adapter coupling 252 includes a structure that connects the proximal end 221 of the flexible tubular member 222 to the adapter coupling 252. Here, the plurality of posts 370 extend outward from the anterior surface 302 of the adapter coupling 252 and are at the bridge plate 372 at a location that is totally centered over the anterior surface 302 of the adapter coupling 252. , With a coupling 374 of a flexible tubular member 222 connected to the bridge plate 372, connected to the bridge plate 372 at the protruding end of the post 370. Wires 298a and 298b extend from the lever assembly through the inner bore of the coupling 374 and into the proximal end 221 of the flexible tubular member 222 connected to the coupling 374.

Again, with reference to FIGS. 13 and 14, the end effector 100 herein is a smaller length body and smaller length compared to the prior art 4 bar links of FIGS. 1 and 2 having the same operable capability. Has a smaller diameter or width. As such, the end effector 100 herein allows for more precise positioning of the distal end of tool portions 152, 154 and a smaller diameter opening through which the end effector 100 in the closed position would pass. Similarly, the connection paradigm of wire end 298 (46 or 48) to a linear actuator used to allow pulling motion against the wire end moving the wire away from the proximal end 221 of the flexible tubular member 222. Achieved by the pushing force between the wire end 298 connection and the lead screw connection, thus a direct pull of the wire end 298 (46 or 48) by the lead screw connection occurs and the wire end 298 with respect to the drive mechanism. Brings a more secure connection.

Referring now to FIG. 20, the controllable drive mechanism 250, and thus the surgical instrument 220, is movable in the "x" direction by the movement of the housing 256 in the x direction 410 within an additional master housing (not shown). .. The controllable drive mechanism 250 is similarly rotatable around the centerline 344 by rotating the ring gear 400 connected to the controllable drive mechanism 250 and driven by the rotation of the drive motor 408. This allows for controllable rotation of the surgical instrument 100 and the tubular member 222 by rotating in opposite arc directions 402, 404. The master housing can also rotate in a controllable manner around the shaft 412, whereby the housing 256 within the master housing will move in an orbital arc around the shaft 412.

Referring to FIG. 21, the end of the fixture 420 is shown, the outer sheath 422 encloses two flexible tubular members 222 as well as the lighting and camera fixture 426, each of which is a cap with an internal opening 430. It is extensible from 424, and through the opening 430, the tubular member 222 as well as the lighting and camera fixture 426 are selectively extensible. In FIG. 21, the distal end of the flexible tubular member 222 extends outward of the cap 424, thus the flexible coupling 296 of the flexible tubular member 222 is positioned outward of the outer sheath 422. The end of the lighting and camera fixture 426 also extends outward of the cap 424 and thus the sheath 422.

If the controllable drive mechanism 250 rotates around the centerline 344 in directions 402, 404, the distal end of the flexible tubular member 222 also rotates in directions 402, 404 at the cap 424. When the end effector 100 is positioned as shown in FIG. 20, the end effector 100 will rotate in directions 402, 404 around its own centerline 428 (FIG. 21). However, since the bendable coupling 296 is bendable by selectively pulling the wire end 298, the centerline 428 of the end effector 100 and the centerline of the distal end of the flexible tubular member 222 are two bends. Controllably offset by a single angle when one of the possible couplings 296 bends, and by a synthetic double angle when both flexible couplings 296 on the ends of the flexible tubular member 222 bend. obtain. In addition, the sheath 422, and thus the flexible tubular member 222 and the lighting and camera fixture 426 therein, forward or backward along the direction 434 and rotate around the axis 410 (FIG. 20) and thus the direction 430. Can rotate to 432. Further, the flexible tubular member 222, and thus the end effector 100 attached to it, is independently movable in the direction 436 by the independent x-axis movement of the housing 256 to which the flexible tubular member 222 is coupled in the direction 410. .. As used herein, the operator may locate the end of the cap 436 of the sheath 422 at the desired location within the body lumen and then the end of the end effector 100 through the illumination and camera instrument view. Multiple end effectors within the body lumen are due to the fact that each flexible coupling 296 can flex independently in two directions perpendicular to each other and the flexible tubular member 222 can rotate around the axis 344. Can be positioned in the orientation of.

Referring to FIG. 22, an alternative structure of the instrument 420, here the instrument 440, is shown, the outer sheath 442 enclosing two flexible tubular members 222 (FIG. 23) as well as the lighting and camera instrument 446. Each of these is extendable from the cantilever cap 444, which is within the cantilever cap 444 in which the tubular member 222 and the lighting and camera fixture 446 are selectively extendable through it. 450, an opening 452 in which the lens end of the camera 454 of the lighting and camera fixture 446 is located, and a pair of lighting openings 456 into which the lighting device of the lighting and camera fixture 446, eg, It has a pair of illumination openings 456 in which the ends of the light emitting diode or light guide 458 are located.

In contrast to the cap 424 of FIG. 21, the cap 444 is an opening from which the end effector 100 and the flexible coupling 296 on the distal end of the tubular member 222 are selectively extendable, as shown in FIG. Includes an extension portion 460 extending further from the distal end 452 of the outer sheath 442, as compared to an extension portion of the cap 424 having.

FIG. 24 shows the structure of the instrument handle 462 for use with the flexible tubular member 222. Here, the handle 462 includes two introduction portions 464, into which the distal end of the flexible tubular member 222 is introduced and extends to the distal end 452 of the outer sheath. The pair of dials 466 and 468 are user controllable to move the distal end 452 of the outer sheath in two degrees of freedom in order to orient the distal end 452 of the outer sheath 442 in the desired direction.

By extending the camera in front of the location of the cap 444 from which the end effector exits, the camera 446 becomes closer to the surgical site within the patient and also, for example, a wide-angle camera with a 120 degree field of view for diagnosis. While available, the same camera 446 provides close-up visibility of the surgical site and end effector 100 as shown in FIG. 25 as its lens moves anterior to the end of the stretched portion 460, the surgeon. Alternatively, it allows better visibility and control of the end effector 100 by other operators of the end effector.

Referring to FIG. 26, a further alternative structure of the instrument 420, here the end of the instrument 470, is shown, the outer sheath 472 with two flexible tubular members, a flexible coupling 296, and an end effector 100. , Lighting and camera fixtures 476. As with the devices described above, the end effector 100 and the bendable coupling are selectively extendable through the openings provided within the end cap 474. Here, in contrast to the structure of FIGS. 22-25 herein, the lighting and camera fixture 476 includes two cameras 480, 482 and two, such as a light emitting diode or ride guide 490 exposed through an aperture. Lighting elements are provided through the end caps 474. Here, the camera 480 is a wide-angle view camera having a field of view of 120 degrees, and the camera 482 has a narrow-angle view on the order of less than 90 degrees.

As a result, a wide-angle camera is used to scan the internal location of the body during diagnostic use or phase of the procedure, as shown in FIG. 27A, and then the site using the end effector 100, as shown in FIG. 27B. A smaller angle of view can be used while performing the surgical procedure in.

Claims (18)

In a mechanism for controllingly moving a wire within a flexible tubular member, said wire is a mechanism comprising an opposing wire end extending outwardly of the proximal end of the flexible tubular member.
Drive mechanism and
With a coupling placed between the drive mechanism and the wire end, movement of the coupling in the direction of the wire end results in an opposed movement of the wire end.
The coupling is a fulcrum and lever having a fixed location with respect to the proximal end of the flexible tubular member, the first end, the second end, and the first end and said. A mechanism further comprising a lever having a swivel connection with said fulcrum to and from a second end . The mechanism of claim 1 , wherein the coupling further comprises a plunger extending from the first end of the lever. An adapter housing positioned between the drive mechanism and the proximal end of the flexible tubular member, comprising at least one bore extending through the adapter housing.
The mechanism of claim 2 , further comprising a bushing that is reciprocally movable within the at least one bore, the end of the bushing being connected to the plunger. The mechanism of claim 2 , wherein the wire end is connected to the second end of the lever. In a mechanism for controllingly moving a wire within a flexible tubular member, said wire is a mechanism comprising an opposing wire end extending outwardly of the proximal end of the flexible tubular member.
Drive mechanism and
With the coupling placed between the drive mechanism and the wire end
The movement of the coupling in the direction of the wire end results in an opposed movement of the wire end.
The coupling is a fulcrum having a fixed location with respect to the proximal end of the flexible tubular member, and a lever, the first side, the second side, and the first side and said. A mechanism further comprising a lever having a swivel connection with said fulcrum to and from a second side. The mechanism of claim 5 , wherein the coupling further comprises a plunger extending from the first side of the lever. An adapter housing positioned between the drive mechanism and the proximal end of the flexible tubular member, comprising at least one bore extending through the adapter housing.
6. The mechanism of claim 6 , further comprising a reciprocally movable bushing within the at least one bore, the end of the bushing being connected to the plunger. The mechanism of claim 6 , wherein the wire end is connected to the second side of the lever. In a mechanism for controllingly moving a wire within a flexible tubular member, said wire is a mechanism comprising an opposing wire end extending outwardly of the proximal end of the flexible tubular member.
Drive mechanism and
With the coupling placed between the drive mechanism and the wire end
The movement of the coupling in the direction of the wire end results in an opposed movement of the wire end.
An adapter housing positioned between the drive mechanism and the proximal end of the flexible tubular member.
A fulcrum extending from the adapter housing, and a lever, a first side, a second side, and a swivel connection with the fulcrum between the first side and the second side. A mechanism that further comprises a lever. 9. The mechanism of claim 9 , wherein the adapter housing further comprises a plunger extending from the first side of the lever and a wire end connected to the second side of the lever. In a mechanism for controllingly moving a wire within a flexible tubular member, said wire is a mechanism comprising an opposing wire end extending outwardly of the proximal end of the flexible tubular member.
With the housing
A lever having a fulcrum extending from the housing and a second side opposite to the first side, the first side of the lever and the second side opposite the lever. With a lever rotatably connected to the fulcrum at a position between
The mechanism. 11. The mechanism of claim 11 , further comprising a plunger connected to the first side of the lever and a wire end connected to the second side of the lever. The bore extending inward of the housing and
12. The bushing is further comprising a bushing disposed in the bore, the bushing being sized to be able to reciprocate in the bore, and the bushing being connected to the plunger, claim 12 . mechanism. Further equipped with a controllable drive mechanism with a second coupling,
The second coupling comprises a wire actuating member that is selectively movable with respect to the second coupling.
13. The mechanism of claim 13 , wherein the bushing is selectively engageable with the wire actuating member. 14. The mechanism of claim 14 , wherein the bushing comprises an opposing end and a recess extending inward of one of the opposing ends. 15. The mechanism of claim 15 , further comprising a magnetic material disposed inward of the recess. 16. The mechanism of claim 16 , wherein the wire actuating member further comprises a magnetic material. 17. The mechanism of claim 17 , wherein the magnetic material comprises either a magnet or a ferromagnetic material.

Images